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Titolo:
Successful valve-sparing in aortic root reconstruction under endoscopic guidance
Autore:
Ohtsubo, S; Itoh, T; Natsuaki, M; Furukawa, K; Yoshikai, M; Suda, H; Minato, N;
Indirizzi:
Saga Med Sch, Dept Thorac & Cardiovasc Surg, Saga, Japan Saga Med Sch Saga Japan Sch, Dept Thorac & Cardiovasc Surg, Saga, Japan
Titolo Testata:
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
fascicolo: 4, volume: 17, anno: 2000,
pagine: 420 - 425
SICI:
1010-7940(200004)17:4<420:SVIARR>2.0.ZU;2-2
Fonte:
ISI
Lingua:
ENG
Soggetto:
ASCENDING AORTA; REIMPLANTATION; REPLACEMENT; OPERATIONS; ANEURYSM; FAILURE;
Keywords:
aortic insufficiency; valve-sparing; ascending aneurysm; endoscopy;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
11
Recensione:
Indirizzi per estratti:
Indirizzo: Ohtsubo, S Saga Med Sch, Dept Thorac & Cardiovasc Surg, Saga, Japan Saga Med Sch Saga Japan horac & Cardiovasc Surg, Saga, Japan
Citazione:
S. Ohtsubo et al., "Successful valve-sparing in aortic root reconstruction under endoscopic guidance", EUR J CAR-T, 17(4), 2000, pp. 420-425

Abstract

Objective: Aortic insufficiency (AI) associated with ascending aneurysm can be corrected by valve-sparing aortic root reconstruction ('David' reimplantation, 'Yacoub' remodeling). Intraoperative endoscopic evaluation in the aortic root may help to clarify the procedure and to access competence of the preserved valve. Methods: Following cross-clamping of the ascending aorta, an endoscopy was inserted into the proximal aortic root. Perfusion of crystalloid cardioplegia enabled the visualization of the pressure-loaded valve in the closed position. Conventional macroscopic evaluation would have overlooked valve prolapse because of a release from perfusion pressure. Valve coaptation was imaged directly before and after the valve-sparing procedure. A total of 17 patients underwent aortic root reconstruction under endoscopic guidance. Indications of the valve-sparing were determined with endoscopic findings. The degree of Al before and after the surgery was evaluatedby aortography and scored (0, none; 1 trivial; 2, mild; 3, moderate; 4, severe). Results: Remodeling was employed to eight patients and reimplantation to four. The other five patients were replaced with prosthetic valved-conduit. There was no early and late mortality. Before and after the valve-sparing surgery, grades of AI were significantly reduced. Three patients who underwent reimplantation procedure required late valve replacement for late progression of AI, however, none of the patients with remodeling required reoperation. Conclusion: Introduction of an endoscopy successfully reduced postoperative AI and clarified indications and limitations of valve-sparing aortic root operations. (C) 2000 Elsevier Science B.V. All rights reserved.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 17/01/21 alle ore 18:14:57